To examine power and governance arrangements in food and nutrition policy formulation and agenda-setting in South Africa

Analysis of the policy implementation environment and in-depth interviews were conducted focussing on: existing policy content and priorities across food system sectors; institutional structures for cross-sectoral and external stakeholder engagement; exercise of power in relation to food system policies; and opportunities to strengthen action on nutrition.

South Africa

Interviews were conducted with 48 key stakeholders involved in the food and nutrition policy sphere: government sectors relevant to food systems (n=21), the private sector (n=4), academia (n=10), NGOs (n=11) and farmers (n=2).

This study found that there are power dynamics involved in shaping the planning agenda that is inadvertently generating a food system that undermines the right to food. The concept of nutrition governance remains poorly defined and applied in different ways and usually based on a relatively narrow interpretation – therefore limiting policy coherence and coordination. South Africa has strong legal institutions and practices, and social policies that support public provisioning of food, but a non-interventionist approach to the food system.

The right to food and nutrition, as outlined in the South African Constitution, has not yet been effectively utilized to establish a robust normative and legal basis for tackling the dual challenges of food insecurity and malnutrition. Currently, the governance of the food system is grappling with substantial obstacles, balancing the influence of powerful stakeholders who uphold the status quo against its responsibilities for food justice.

Despite commitment by many countries to promote food system transformation, Australia has yet to adopt a national food policy. This study aimed to evaluate Australian Federal Government’s (AFG) food policies and policy actions potential to promote healthy and sustainable food systems.

This study is a desk-based policy mapping followed by a theoretically guided evaluation of policy actions. This involved three steps: (1) identification of government departments and agencies that could influence Australia’s food system; (2) identification of food policies and policy actions within these departments and (3) use of a conceptual framework to evaluate policy actions’ potential of changing the food system as adjust (first-order change), reform (second-order change) or transform (third-order change).

Australia.

None.

Twenty-four food policies and sixty-two policy actions were identified across eight AFG departments and the Food Regulation System and evaluated based on the order of change they represented. Most policies were led by individual departments, reflecting the absence of a joined-up approach to food policy in Australia. Most policy actions (n 25/ 56·5 %) were evaluated as having adjust potential, whereas no transformative policy action was identified.

These findings suggest that Australia is likely to proceed incrementally towards achieving food system change through adjustments and reforms but lacking transformative impact. To promote transformative change, all three orders of change must be strategically implemented in a coherent and coordinated matter. A comprehensive national food policy and a national coordinating body are needed to ensure a cohesive approach to policy.

Partnerships between public, private and civil society actors can potentially address food systems challenges. However, such cross-sector partnerships may require the management of potential tensions and conflicts of interest. This article presents the development and content of a framework for engagement between food systems actors involved in NewTools, a cross-sector research partnership involving twenty-eight partners from research institutions, government, food industry and civil society. The purpose of the framework is to facilitate engagement of partners and maintain research integrity.

This two-phased, iterative study was conducted in 2022. It was guided by recommendations for methodological framework development and was informed by existing frameworks and recommendations as well as two rounds of consultations with partners.

The Norwegian cross-sector research partnership NewTools that aims to develop two food profiling models: one for dietary quality and one for environmental and social impact.

Food systems actors involved in the NewTools project.

The NewTools framework consists of four main parts: (1) definition of overarching principles for collaboration (transparency, regular information, adhering to defined roles and responsibilities), (2) descriptions of roles and responsibilities of the partners involved, (3) procedures to ensure involvement and transparency and (4) identification and mediation of potential conflict areas.

This article provides an example of how a cross-sector research partnership developed a framework to facilitate engagement between partners with different interest within a food system. Future studies are needed to assess the potential value of frameworks for cross-sector research partnerships towards healthier and more sustainable food systems.

To examine how aligned the UK food supply is with the Eatwell Guide and identify discrepancies that should be addressed to support the availability of healthy diets for the population.

A dietary gap assessment was carried out on the 2022 UK food supply with FAOSTAT Food Balance Sheets (FAO-FBS) data, including domestic production, imports and exports and excluding animal feed, seeds and non-food uses. Foods were grouped into potatoes and cereals, oils and spreads, dairy products, protein, fruit and vegetables and sugar. The percentage contribution of each food group to the food supply was compared with the Eatwell Guide. An overview of the food supply from 2010 to 2022 was also created. To triangulate the data, FAO-FBS data were compared with the 2022 data from the Department for Environment, Food and Rural Affairs (DEFRA).

UK, 2010–2022

N/A

The proportion of fruit and vegetables, potatoes and cereals in the UK food supply was lower than the Eatwell Guide, while dairy products and oil were higher. Only 7 % of the food produced in the UK in 2022 was fruit and vegetables. This was the second smallest proportion, after oils and spreads (6 %), and about half the amount of sugar beet produced (13 %).

Although the relationship between food supply and consumption is complex, taking a more coherent approach by integrating dietary recommendations with the food supply could help increase the availability of the recommended healthy diet. Going forward, DEFRA should include dietary gap assessments in future Food Security Reports.

The NewTools project aims to support the transformation of the food system by developing summary scores for the nutritional value and environmental and social sustainability of foods and exploring potential applications. In this conceptual paper, we present the governance, objectives, conceptualisation and expected outcomes of the NewTools project.

A cross-sector research partnership involving actors across the Norwegian food system.

The need to transform food systems both globally, regionally and nationally.

A broad constellation of twenty-eight project partners includes research institutions, governmental agencies, food industry and Non-governmental organization (NGO).

Outputs from the project will include the development and testing of a score for nutritional quality using the European Nutri-Score version 2023 as a starting point, identifying of indicators to measure social and environmental sustainability, proposing weighting of these into one or several summary scores, pilots testing potential applications of use for the scores and protocols for relevant spin-off projects.

The multitude of perspectives represented by this unique variety of partners is seen as valuable to better understand the opportunities and limitations of the proposed tools designed to foster transformations towards a more resilient and sustainable food system.

This paper explored international experts’ views on what influences the development and implementation of local government (LG) planning policy to support healthy food retail environments; and 2) whether a rapid group model building (RGMB) approach can successfully be applied to capture valuable insights.

Adaptation of methods from community-based system dynamics in the form of RGMB.

In person, facilitated workshop at the World Public Health Nutrition Congress (WPHNC) June 2024, London, England.

WPHNC delegates.

Sixty-six participants contributed to the RGMB. Factors identified that influence the development and implementation of LG planning to support healthy food retail environments centred around community, evidence, policy, political leadership/priorities and capitalism. Feedback loops identified in the causal loop diagram showed the potential influence of policies to support healthy food retail environments on public health outcomes. Research evidence and data were key factors in supporting community demand for healthy food policies and raising the profile of health as a priority, which, in turn, could support funding to support healthy food environments. Political will and corporate influence in the system were shown to be highly influential.

International experts identified that data is urgently needed to support demand for healthy food policies and political will to address key nutrition issues. The influence of corporate interests was viewed as highly influential over the current system across the world. RGMB workshop activities and processes described in this paper can be used successfully to capture expert insights into complex problems using interactive technologies.

This paper aims to summarise the frameworks currently used to analyse food policymaking processes and to critically assess whether those frameworks can be applied to the analysis of integrated, ‘systems’ approaches to policymaking.

Two electronic databases were searched to identify publications analysing food policymaking processes. Data from the publications were charted using an iterative coding process, and details of the underlying analytical frameworks were recorded. Identified frameworks were evaluated using theories of systems approaches to food policy development.

Governmental food policy at the supranational, national and local levels.

The search process yielded 532 results. After screening, a final forty-three publications and twenty-four frameworks were identified. In the studies, frameworks were used to analyse agenda-setting, stakeholder networks, policy coherence and development of national food and nutrition policies. All twenty-four frameworks allowed for analysis of actors and context in policymaking processes, while space for considering policy coherence featured less (n 11).

Three frameworks were highlighted as particularly applicable to the context of food systems approaches to policymaking. The application of analytical frameworks for policymaking processes is limited in food policy research. However, this review demonstrates that there are considerable benefits to using such frameworks to understand the ideas, knowledge, power and decision-making that lead to food policy development. This is particularly useful in understanding the complex stakeholder networks and policy coherence necessary for successful policies for sustainable food systems.

Local governments have an important role to play in creating healthy, equitable and environmentally sustainable food systems. This study aimed to develop and pilot a tool and process for local governments in Australia to benchmark their policies for creating healthy, equitable and environmentally sustainable food systems.

The Healthy Food Environment Policy Index (Food-EPI), developed in 2013 for national governments, was tailored to develop the Local Food Systems Policy Index (Local Food-EPI+) tool for local governments. To incorporate environmental sustainability and the local government context, this process involved a literature review and collaboration with an international and domestic expert advisory committee (n 35) and local government officials.

Local governments.

The tool consists of sixty-one indicators across ten food policy domains (weighted based on relative importance): leadership; governance; funding and resources; monitoring and intelligence; food production and supply chain; food promotion; food provision and retail in public facilities and spaces; supermarkets and food sources in the community; food waste reuse, redistribution and reduction; and support for communities. Pilot implementation of the tool in one local government demonstrated that the assessment process was feasible and likely to be helpful in guiding policy implementation.

The Local Food-EPI+ tool and assessment process offer a comprehensive mechanism to assist local governments in benchmarking their actions to improve the healthiness, equity and environmental sustainability of food systems and prioritise action areas. Broad use of this tool will identify and promote leading practices, increase accountability for action and build capacity and collaborations.

The emerging concept of ‘food justice’ describes a social movement and a set of principles. It align with the goals of social justice, demanding recognition of human rights, equal opportunity, fair treatment and is participatory and community specific. The aim of this study was to investigate the conceptualisation of food justice and to explore how community participation is positioned in food justice scholarship.

A scoping review of peer-reviewed literature was conducted using the term ‘food justice’. This study used a five-step scoping review protocol. The databases included Scopus, Web of Science and Medline (OVID). Data were extracted on country of origin, research discipline, study type and conceptualisations of food justice. Reflexive thematic analysis was used to identify the themes.

The search identified 546 abstracts of which ninety peer-reviewed studies met the inclusion criteria. Thematic analysis identified five themes of food justice across these ninety studies: (1) social equity, (2) food security, (3) food systems transformation, (4) community participation and agency and (5) environmental sustainability.

Current conceptualisations of food justice are evolving. Together, these five themes, using the term food justice, embrace a more holistic and structural view of the food system. They emphasise healthy, sustainable and equitable food as a human right and acknowledge the need to address structural barriers to that right. Community participation and agency in food justice decision-making is critical for transformative change towards a healthy, sustainable, and more just food system.

Childhood obesity prevention is critical to reducing the health and economic burden currently experienced by the Australian economy. System science has emerged as an approach to manage the complexity of childhood obesity and the ever-changing risk factors, resources and priorities of government and funders. Anecdotally, our experience suggests that inflexibility of traditional research methods and dense academic terminology created issues with those working in prevention practice. Therefore, this paper provides a refined description of research-specific terminology of scale-up, fidelity, adaptation and context, drawing from community-based system dynamics and our experience in designing, implementing and evaluating non-linear, community-led system approaches to childhood obesity prevention.

We acknowledge the importance of using a practice lens, rather than purely a research design lens, and provide a narrative on our experience and perspectives on scale-up, fidelity, context and adaptation through a practice lens.

Communities.

Practice-based researcher experience and perspectives.

Practice-based researchers highlighted the key finding that community should be placed at the centre of the intervention logic. This allowed communities to self-organise with regard to stakeholder involvement, capacity, boundary identification, and co-creation of actions implemented to address childhood obesity will ensure scale-up, fidelity, context and adaptation are embedded.

We need to measure beyond primary anthropometric outcomes and focus on evaluating more about implementation, process and sustainability. We need to learn more from practitioners on the ground and use an implementation science lens to further understand how actions work. This is where solutions to sustained childhood obesity prevention will be found.

Food systems are a major contributor to climate change, producing one-third of global greenhouse gas emissions. However, public knowledge of food systems’ contributions to climate change is low. One reason for low public awareness may be limited media coverage of the issue. To investigate this, we conducted a media analysis examining coverage of food systems and their contribution to climate change in Australian newspapers.

We analysed climate change articles from twelve Australian newspapers between 2011 and 2021, sourced from Factiva. We explored the volume and frequency of climate change articles that mentioned food systems and their contributions to climate change, as well as the level of focus on food systems.

Australia.

N/A.

Of the 2892 articles included, only 5 % mentioned the contributions of food systems to climate change, with the majority highlighting food production as the main contributor, followed by food consumption. Conversely, 8 % mentioned the impact of climate change on food systems.

Though newspaper coverage of food systems’ effects on climate change is increasing, coverage of the issue remains limited. As newspapers play a key role in increasing public and political awareness of matters, the findings provide valuable insights for advocates wishing to increase engagement on the issue. Increased media coverage may raise public awareness and encourage action by policymakers. Collaboration between public health and environmental stakeholders to increase public knowledge of the relationship between food systems and climate change is recommended.

The mother–child breastfeeding dyad is a powerful force for achieving healthy, secure and sustainable food systems. However, food system reports exclude breastfeeding and mother’s milk. To help correct this omission and give breastfeeding women greater visibility in food systems dialogue and action, we illustrate how to estimate mother’s milk production and incorporate this into food surveillance systems, drawing on the pioneering experience of Norway to show the potential value of such analysis.

The estimates use data on the proportion of children who are breastfed at each month of age (0–24 months), annual number of live births and assumptions on daily human milk intake at each month. New indicators for temporal and cross-country comparisons are considered.

It is assumed that a breastfeeding mother on average produces 306 l of milk during 24 months of lactation.

The annual number of live births is from Statistics Norway. Data for any breastfeeding at each month of age, between 0 and 24 months, are from official surveys in 1993, 1998–1999, 2006–2007, 2013 and 2018–2019.

Estimated total milk production by Norwegian mothers increased from 8·2 to 10·1 million l per year between 1993 and 2018–2019. Annual per capita production increased from 69 to 91 l per child aged 0–24 months.

This study shows it is feasible and useful to include human milk production in food surveillance systems as an indicator of infant and young child food security and dietary quality. It also demonstrates significant potential for greater milk production.

To define a generic diet to protect human health and food system sustainability based on three dimensions: animal:plant ratio, degree of food processing and food diversity.

The percentages of maximum animal and ultra-processed energy content were evaluated from scientific papers (Web of Science database) and reports from international scientific institutions. Then, a weekly French standard diet, including these percentages and food diversity (≥42 different foods), was designed to calculate adequacy to nutritional needs.

Based on traditional and scientifically based healthy diets, and on foresight scenarios for sustainable diets at horizon 2050, a median daily animal energy content intake of 15 % was found to be protective towards both human health and environment. Based on epidemiological studies associating ultra-processed energy consumption with increased overweight/obesity risk, a precautionary threshold of approximately 15 % ultra-processed energy content was observed. The French diet allows addressing all nutritional needs and other nutritional indicators such as maximum salt and simple sugar consumption, α-linolenic acid:linoleic acid ratio and essential amino acids. This diet was named the ‘3V rule’ for Végétal (plant), Vrai (real) and Varié (varied, if possible organic, local and seasonal). This generic diet can be adapted according to regional traditions and environmental characteristics. Excluding only one dimension of it would threaten both health and food system sustainability.

Tending towards a 3V-based diet, while respecting local constraints, should allow preserving human health, environment (greenhouse gas emissions, pollution, deforestation, etc.), small farmers, animal welfare and biodiversity, culinary traditions and socioeconomics (including an alleviation of public health cost).

This study uses participatory modelling with stakeholders to assess the potential impacts of three interventions intended to increase fruit and vegetable (F&V) consumption in urban Kenya.

A participatory process using Group Model Building (GMB) developed a conceptual model of the determinants of vegetable consumption. A subsequent quantitative System Dynamics model using data from primary and secondary sources simulated vegetable consumption from 2020 to 2024 under three proposed interventions suggested by stakeholders: increasing consumer awareness, reducing post-harvest losses and increasing farm yields. Model analyses assumed mean parameter values and assessed uncertainty using 200 simulations with randomised parameter values.

The research was implemented in Nairobi, Kenya with simulation analyses of mean per capita consumption in this location.

Workshops convened diverse F&V value chain stakeholders (farmers, government officials, NGO staff and technical experts) to develop the conceptual model, data inputs and intervention scenarios.

Increasing consumer awareness was simulated to increase vegetable consumption by relatively modest amounts by 2024 (5 g/person/d from a base of 131 g/person/d) under mean assumed value of value chain response parameters. Reducing perishability was simulated to reduce consumption due to the higher costs required to reduce losses. Increasing farm yields was simulated to have the largest impact on consumption at assumed parameter values (about 40 g/person/d) but would have a negative impact on farm profits, which could undermine efforts to implement this intervention.

The combination of GMB and simulation modelling informed intervention priorities for an important public health nutrition issue.